Hospitals lagging in IT to meet meaningful use

Most hospital and physician offices have their work cut out for them to meet the health IT meaningful use requirements of the HITECH Act, according to a new study – and they will only do so by carefully architecting IT solutions to capture and manage data in a way that’s intuitive for clinicians.

The study from HIMSS Analytics maps the requirements of the stimulus law to the organization’s own seven-stage EMR Adoption Model (EMRAM). The results identify implementation gaps that need to be bridged if the health care industry is to meet the 2015 targets for meaningful use.

Certain parts of the process will be relatively easy. The study’s author, HIMSS Analytics’ vice president Michael Davis, points out that the 2011 HITECH measurements that require first stage EMRAM functionality – installation of laboratory, radiology and pharmacy information systems – can already be met by some 90 percent of the relevant hospital departments.

After that, however, things get progressively trickier. The only Stage 2 requirement for the 2011 measurements, for example, is the ability to store lab results in structured formats such as Logical Observation Identifiers Names and Codes (LOINC), but many hospitals can’t do that yet.

Measurements that require Stage 3 functionality is where the real challenges start to turn up. The higher levels of clinical decision support systems that will be needed have so far been implemented by less than a quarter of the healthcare market, for example, and there are broad differences among systems in the ease with which they allow data elements to be added.

The 2013 HITECH measures ratchet things up significantly. Orders will need to be tracked through a computer physician order entry (CPOE) system, an EMRAM Stage 4 capability, but less than half of U.S. hospitals have it, only some 11 percent of physicians managing patients in hospitals use it, and under five percent of hospitals require their doctors to use CPOE.

Similarly, the HIMSS study points out, hospitals are lagging in their ability to provide such things as portals that patients can use to get access to their medical records. Few hospitals have so far chosen to even participate in data sharing projects.

Measures for 2015 are not so well-defined yet, but at the least they suggest that substantial data sharing and reporting on defined metrics will be  a major requirement, Davis writes. That means that the adoption of CPOE by physicians will have to increase substantially by then. Also, all hospitals will have to implement clinical data warehouses.

So, Davis concludes, though hospitals that have achieved the EMRAM stage 3 capabilities are well positioned to meet the 2011 ARRA requirements, by 2015 they will need to have the majority of their physicians using stage 6 applications, with completely electronic medical records in place.

Only those organizations that understand those needs will survive the upcoming healthcare delivery transformation, he said.

Government Health IT magazine is published by HIMSS.